AUGUSTA — A blue ribbon commission of the Maine Legislature on Tuesday discussed ways to reform services for children with disabilities and older adults a week after the U.S. Department of Justice filed suit against the Mills administration for failing to provide disabled children access to services.
State Rep. Dan Shagoury, D-Hallowell, said the Justice Department lawsuit will hopefully spur much-needed changes.
“Within the past week, an 800-pound gorilla fell into this room,” Shagoury said, referring to the lawsuit.
The 13-member commission, which the Legislature created in July 2023 to study the organization and delivery of services by the Department of Health and Human Services, met for the sixth time Tuesday and is scheduled to meet twice more – Oct. 7 and Oct. 30 – before formulating its final recommendations.
While Mills administration officials have expressed disappointment with the lawsuit, they also have said they are continuing discussions with the Justice Department to try to settle the lawsuit.
The lawsuit – if it’s not settled – could result in a trial or a consent decree, under which some DHHS programs are taken over by a court.
The lawsuit, filed on Sept. 9 in U.S. District Court in Portland, says that too many children who are entitled to receive community-based care are on monthslong waiting lists, languishing in hospital emergency departments or in other institutions. Long Creek Youth Development Center is being used as a “de facto children’s psychiatric facility,” the lawsuit says.
More than 400 children are on waiting lists for certain behavioral health and developmental disability services, according to the lawsuit.
“Absent these services, Maine children with disabilities enter emergency rooms, come into contact with law enforcement and remain in institutions, when they could remain with their families if Maine provided them sufficient community-based services,” the Department of Justice said.
The blue ribbon commission, which is made up of lawmakers, advocates and state officials, is tasked with coming up with solutions to improve DHHS’ services, including services for children and older adults.
Nancy Cronin, executive director of the Maine Developmental Disabilities Council, a quasi-governmental agency funded by federal and state dollars, presented an eight-point plan to improve services for children with disabilities.
She said there are many gaps in services, and the services are often “siloed” so children who have complex needs – such as those with co-occurring medical conditions, mental health challenges and intellectual disabilities – fall through the cracks.
The result is a “disjointed, transactional experience with multiple programs with multiple doors and rules,” she said.
“These unsynchronized programs create real risks for children to fall through gaps,” Cronin said.
Cronin said that DHHS should create a management-level position whose sole responsibility is to merge or coordinate various systems so that children can get the help they need.
Cronin said the state’s juvenile corrections system should work more with Maine’s behavioral health programs to ensure that children who are dealing with the corrections system and have behavioral health conditions get the help they need.
REIMBURSEMENT RATES LAG
Cronin and other committee members also said that reimbursement rates need to improve to help attract and retain employees. While reimbursement rates have recently increased, the nonprofit agencies that often provide the services have said that the increase wasn’t enough to keep up with what other employers are paying their workers. So Maine’s workforce shortage, already tight, is even worse in these direct-care jobs that are demanding and don’t pay enough to keep services robust, advocates have said.
Committee member Rob Moran said the workforce shortage is so acute that child welfare caseworkers are often overwhelmed.
“We need to have robust enough funding so that we can have manageable case numbers for case managers,” Moran said. “That’s a huge problem.”
Sen. Marianne Moore, R-Washington, said that she has heard about many payment delays from DHHS to foster parents and health care providers, which can cause cash flow problems. She said if the state can’t improve its payment processing, that is a service that could be contracted out to a private contractor.
Cronin said that the problems are daunting and complex.
“Maine must serve our most vulnerable children,” she said. “It’s not going to be easy to fix, but we can do it.”
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